HomeMy WebLinkAboutC2008-331 - 9/9/2008 - Approved
DAVID L. LAKEY, M.D.
COMMISSIONER
September 24, 2008
Dear Contractor:
P.O. Box 149347
Austin, Texas 78714-9347
1-888-963-7111
TTY: I-800-735-2989
www.dshsstate.[x. us
Enclosed is an approved copy of your Department of State Health Services (DSHS) contract.
Please file it with the office of record for your agency.
The provisions of this contract require submittal of quarterly financial reports no later than 30
days after the end of the first three quazters and a final report no later than 60 days after the end
of the contract term. Attached aze preprinted Financial Status Reports (FSR 269a) for the entire
term of your contract. Please forward' the FSR forms to the person in your agency
responsible for completion of financial reports. If this is a contract amendment, FSRs are
provided only for the remaining term of your contract. These reports aze required regardless of
whether or not expenses are incurred.
DSHS will not pay for reimbursements submitted/postmazked more than 60 days after the end of
the contract Attachment term. Additional information regarding this policy is available on the
DSHS website at http://www.dshs.state.tx.us.
Please reference the DSHS contract and attachment number in all future correspondence. If you
have questions, please contact LindaFaye Smith at 512-458-7111 ext. 2044 or via email at
lindafaye. smith(c~dshs.state.tx.us.
Sincerely,
Bob Burnette, Director
Client Service Contracting Unit
Enclosures
2008-331
09/09/08
Res. 027828
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
Tx. Dept. of St. Health Svcs. ial Employment Opportunity Employer and Provider INDEXED
DEPARTMENT OF STATE HEALTH SERVICES
This contract, number 2009-028291 (Contract), is entered into by and between the Department
of State Health Services (DSHS or the Department), an agency of the State of Texas, and
CORPUS CHRISTI-NUECES COUNTY PUBLIC HEALTH DISTRICT (CITY) (Contractor),
a Government Entity. (collectively, the Parties).
1. Purpose of the Contract. DSHS agrees to purchase, and Contractor agrees to provide,
services or goods to the eligible populations as described in the Program Attachments.
2. Total Amount of the Contract and Payment Method(s). The total amount of this Contract
is $241,637.00, and the payment method(s) shall be as specified in the Program Attachments.
3. Funding Obligation. This Contract is contingent upon the continued availability of funding.
If funds become unavailable through lack of appropriations, budget cuts, transfer of funds
between programs or health and human services agencies, amendment to the Appropriations Act,
health and human services agency consolidation, or any other disruptions of current appropriated
funding for this Contract, DSHS may restrict, reduce, or terminate funding under this Contract.
4. Term of the Contract. This Contract begins on 09/01/2008 and ends on 08/31/2009. DSHS
has the option, in its sole discretion, to renew the Contract as provided in each Program
Attachment. DSHS is not responsible for payment under this Contract before both parties have
signed the Contract or before the start date of the Contract, whichever is later.
5. Authority. DSHS enters into this Contract under the authority of Health and Safety Code,
Chapter 1001.
6. Documents Forming Contract. The Contract consists of the following:
a. Core Contract (this document)
b. Program Attachments:
2009-028291-001 IMMUNIZATION BRANCH -LOCALS
c. General Provisions (Sub-recipient)
d. Solicitation Document(s), and
e. Contractor's response(s) to the Solicitation Document(s).
f. Exhibits
Any changes made to the Contract, whether by edit or attachment, do not fonn part of the
Contract unless expressly agreed to in writing by DSHS and Contractor and incorporated herein.
92648-1
7. Conflictin¢ Terms. In the event of conflicting terms among the documents forming this
Contract, the order of control is first the Core Contract, then the Program Attachment(s), then the
General Provisions, then the Solicitation Document, if any, and then Contractor's response to the
Solicitation Document, if any.
8. Payee. The Parties agree that the following payee is entitled to receive payment for services
rendered by Contractor or goods received under this Contract:
Name: CITY OF CORPUS CHRISTI
Address: PO BOX 9277
CORPUS CHRISTI, TX 78469-9277
Vendor Identification Number: 17460005741027
9. Entire Agreement. The Parties acknowledge that this Contract is the entire agreement of
the Parties and that there are no agreements or understandings, written or oral, between them
with respect to the subject matter of this Contract, other than as set forth in this Contract.
92648-I
By signing below, the Parties acknowledge that they have read the Contract and agree to its
terms, and that the persons whose signatures appear below have the requisite authority to execute
this Contract on behalf of the named party.
DEPARTMENT OF STATE HEALTH SERVICES CORPUS CHRISTI-NUECES COUNTY PUBLIC
`~ ^~"`HEALTH )STRICT (CITY) /
By: /0 By: i- l~.rw
Signature of Authorized Official Sign
9 /1y lD~
Dates
Bob Burnette, C.P.M., CTPM
Director, Client Services Contracting Unit
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756
(512) 458-7470
Bob.Burnette@dshs. state.tx.us
~i9 ~~°Te
Date
Printe Name and Titl~
Address
~'~,~ CE~t~-i~.~R 7g~~
City, State, Zip '
(~i ~ 8e2(~ 3aao
Telephone Number
E-mail Address for Official Correspondence
1o tOtt11:
Assi>~M CttY Attorney
For City Attorney
dT C-0UNCII
~`TTEST. -.h -
ANDO CHP.PA T~
CITY uECREfAR"
92648-I
Fiscal Year 2009 Department of State Health Services Contract
General Provisions
(CorelSubrecipient)
TABLE OF CONTENTS
ARTICLE I COMPLIANCE AND REPORTING ......................................................................1
Section 1.01 Compliance with Statutes and Rules ...................................................................1
Section 1.02 Compliance with Requirements of Solicitation Document ...............................1
......
1
Section 1.03 P g .........................................................................................................
Re ortin
1
Section 1.04 Client Eligibility ....................................................................................................
Section 1.05 Applicable Contracts Law and Venue for Disputes ...........................................1
Section 1.06 Applicable Laws and Regulations Regarding Funding Sources :.:::::::.:::::::::.2
Section 1.07 Statutes and Standards of General Applicability ....................
Section 1.08 Applicability of General Provisions to Interagency and Interlocal Contracts..
........4
.........................................................................................................................
5
Section 1.09 Civil Rights Policies and Complaints ...............:..................................................
5
ARTICLE II SERVICES .................................................................................................................
Section 2.01 Education to Persons in Residential Facilities ....................................................5
5
02
Section 2 Disaster Services ....................................................................................................
.
Section 2.03 Consent to Medical Care of a Minor ...................................................................5
Section 2.04 Telemedicine Medical Services ............................................................................6
Section 2.05 Fees for Personal Health Services .......................................................................6
Section 2.06 Cost Effective Purchasing of Medications ..........................................................6
Section 2.07 Services and Information for Persons with Limited English Proficiency.......6
7
ARTICLE III FUNDING ..................................................................................................................
Section 3.01 Debt to State and Corporate Status ....................................................................7
Section 3.02 Application of Payment Due ................................................................................7
..7
03
Section 3 Use of Funds ........................................................................................................
.
Section 3.04 Use for Match Prohibited .....................................................................................7
7
Section 3.05 Program Income ........................................:...........................................................
8
Section 3.06 PP g .....................................................................................................
Nonsu lantin
ARTICLE IV PAYMENT METHODS AND RESTRICTIONS ..................................................8
8
Section 4.01 Payment Methods ..................................................................................................
8
Section 4.02 Billing Submission .................................................................................................
Section 4.03 Final Billing Submission .......................................................................................8
Section 4.04 Worlung Capital Advance ....................................................................................5
Section 4.05 Financial Status Reports (FSRs) ..........................................................................9
9
Section 4.06 Third Party Payors ...............................................................................................
ARTICLE V TERMS AND CONDITIONS OF PAYMENT ......................................................9
9
Section 5.01 Prompt Payment ...................................................................................................
9
:
Section 5.02 ............
Withholding Payments ............................................................................
Section 5.03 Condition Precedent to Requesting Payment ...................................................10
General Provisions (Core Subrecipient 2009) Table of Contents 6/5/08 Page I of 4
...20
................
Section 12.03 Insurance ................................................................ ..........................
20
.
................
Section 12.04 Fidelity Bond .......................................................... ..
..........................
....20
Section 12.05 ................
Liability Coverage .................................................. .........................
....20
Section 12.06 .....
.............
Overtime Compensatton ..................................... ..........................
.......20
Section 12.07 .................
Program Site ......................................................... .......................
...20
Section 12.08 ............................................................
Cost Allocation Plan. ...........................
21
09
12 orting for Unit Rate and Fee For Service Contracts ..................
Re
.
Section p 21
10
12
ti Historically Underutilized Businesses (HUBs)..••••••••••••••••• ••••••••°::::: 21
.
on
Sec
Section 12.11 ...........................................................
Buy Texas .................... ........
,,,,,,,,,21
Section 12.12 Contracts with Subrecipient Subcontractors ..................... ,,,,
................. 22
Section 12.13 Status of Subcontractors ..................................................... ..................
.......22
Section 12.14 Incorporation of Terms ....................................................... ........................
......22
Section 12.15 Independent Contractor ...................................................... .........................
......22
Section 12.16 .............
Authority to Bind .................................................... .........................
•...•.22
17
Section 12 Tax Liability ......................................................................... .•..•
....................
23
.
Section 12.18 .............
Notice of Organizational Change .......................... ...............................
•....•..23
Section 12.19 .............
Quality Management .............................................. .....•...••...•...•••..
23
Section 12.20 Equipment (Including Controlled Assets) Purchases......•••.......••••••••••••••••••••••
.....23
Section 12.21 ..................................................
Supplies ............................ ...........................
.......23
Section 12.22 ....................
Changes to Equipment List ............................ .........................
23
Section 12.23 Property Inventory and Protection of Assets ................... ................................
.....24
24
ction 12
S Bankru tc ............
P Y .............................................................. ...........................
24
.
e
Section 12.25 ............
p rtY ......................................................
Title to Pro e ................................
24
Section 12.26 •...•....•.
......
Property Acquis~ttons ........................................ ...,•••••••••••,••••,,,,,,,,,,,,
.....24
Section 12.27 .................
Disposition of Property ...................................... ...........................
......24
Section 12.28 Closeout of Equipment ...................................................... ...........................
......24
Section 12.29
.......
Assets as Collateral Prohibited ..................................
...........................
.
TICLE XIH GENERAL TERMS ........................................................... ................................
AR 25
01
ction 13
S Assignment .......................................................................... .................................
.
e
Section 13.02 Lobbying ............................................................................. .................................25
.....
Section 13.03
..........................................
Conflict of Interest ...................
............................
Section 13.04 Transactions Between Related Parties ............................. ......................
•• 26
Section 13.05 Intellectual Property ......................................................... ••••••••
.......................
...27
Section 13.06 Other Intangible Property ............................................... ........
.......................
•27
Section 13.07 g tY .............................................
Severability and Ambi u~ ••••••.•••
.......................
27
08
Section 13 Legal Notice ........................................................ 27
.
Section 13.09 Successors .......................................................................... ........................
..........
...27
Section 13.10 Headings ............................................................................. .....................
..........
..27
Section 13.11 Parties ................................................................................. ......................
..........
27
Section 13.12 Survivability of Terms ..................................................... ...................................
...27
Section 13.13 Direct Operation .............................................................. ................................
......28
Section 13.14 Customer Service Information ....................................... .............................
...2 8
Section 13.15
.................................................
Amendment .....................
tain Contr
C
t
................................
act Provisions...........28
16
ction 13
S er
o
Contractor's Notification of Change
.
e
17
13
ti
S Contractor's Request for Revision of Certain Contract Provisions :::.:::::::::29
.
on
ec
Section 13.18 Immunity Not Waived ..................................................... ..................
General Provisions (Core Subrecipient 2009) Table of Contents 6/5/08 Page 3 of 4
Fiscal Year 2009 Department of State Health Services Contract
General Provisions
(Core/Subrecipient)
ARTICLE I COMPLIANCE AND REPORTING
Section 1.01 Compliance with Statutes and Rules. Contractor shall comply, and shall require its
subcontractor(s) to comply, with the requirements of the Department's rules of general applicability
and other applicable state and federal statutes, regulations and rules as such statutes, regulations and
rules currently exist and as they maybe lawfully amended. The Department rules aze located in the
Texas Administrative Code, Title 25 (Rules). To the extent this Contract imposes a higher standazd,
or additional requirements beyond those required by applicable statutes, regulations or the Rules, the
terms of this Contract shall control.
Section 1.02 Compliance with Requirements of Solicitation Document. Except as specified in
these General Provisions or the Program Attachment(s), Contractor shall comply with the
requirements, eligibility conditions, assurances, certifications and program requirements of the
Solicitation Document, if any, (including any revised or additional terms agreed to in writing by
Contractor and DSHS prior to execution of this Contract) for the duration of this Contract or any
subsequent renewals. The Parties agree that the Department has relied upon the Contractor's
response to the Solicitation Document. The Parties agree that any misrepresentation contained in the
Contractor's response to the Solicitation Document shall constitute a breach of this Contract.
Section 1.03 Reporting. Contractor shall submit reports in accordance with the reporting
requirements established by the Departrnent and shall provide any other information requested by the
Department in the format required by DSHS. Failure to submit a required report or additional
requested information by the due date specified in the Program Attachment(s) or upon request
constitutes a breach of contract, may result in delayed payment and/or the imposition of sanctions and
remedies, and, if appropriate, emergency action; and may adversely affect evaluation of Contractor's
future contracting opportunities with the Department.
Section 1.04 Client Eligibility. Where applicable, Contractor shall use financial eligibility criteria,
financial assessment procedures and standazds developed by the Department to determine client
eligibility.
Section 1.05 Applicable Contracts Law and Venue for Disputes. Regazding all issues related to
contract formation, performance, interpretation, and any issues that may arise in any dispute between
the Parties, this Contract shall be governed by, and construed in accordance with, the laws of the
State of Texas. In the event of a dispute between the Parties, venue for any suit shall be Travis
County, Texas.
Section 1.06 Applicable Laws and Regulations Regarding Funding Sources. Where applicable,
federal statutes and regulations, including federal grant requirements applicable to funding sources,
shall apply to this Contract. Contractor agrees to comply with applicable laws, executive orders,
regulations and policies as well as Office of Management and Budget (OMB) Circulars, the Uniform
Grant and Contract Management Act of 1981 (UGMA), Tex. Gov. Code Chapter 783, as amended,
and Uniform Grant Management Standazds (UGMS), as amended, by revised federal circulars and
incorporated in UGMS by the Governor's Budget, Planning and Policy Division. UGMA is located
on the Internet at htt ://tlo2.tlc.state.tx.us/statutes/stattttes.html; the UGMS aze located on the
General Provisions (Core Subrec~pient 2009) 615/08 Page I of 38
k) Texas Workers' Compensation Act, Tex. Lab. Code, Chapters 401-406 and 28 Tex. Admin.
Code Part 2, regazding compensation for employees' injuries;
1) The Clinical Laboratory Improvement Amendments of 1988, 42 USC § 263a, regarding the
regulation and certification of clinical laboratories;
m) 29 CFR §1910. 030,eor Title 25 Ttex. Adm nVCode Chapter 96 regazding afetyesPandards for
handling blood borne pathogens;
n) Laboratory Animal Welfaze Act of 1966, 7 USC §§ 2131 et seq., pertaining to the treatment
of laboratory animals; ualit
o) environmental standazds pursuant to the following: 1) Institution of environmental g4321-
control measures under the National Environmental Policy Act of 1969, 42 USC §§
4347 and Executive Order 11514 (35 Fed. Reg. 4247), "Protection and Enhancement of
Environmental Quaiity;" 2) Notification of violating facilities pursuant to Executive Order
11738 (40 CFR Part 32), "Providing for Administration of the Clean Air Act and the Federal
Water Pollution Control Act with respect to Federal Contracts, Grants, or Loans;" 3)
Protection of wetlands pursuant to Executive Order 11990, 42 Fed. Reg. 26961.; 4) Evaluation
of flood hazazds in floodplains in accordance with Executive Order 11988, 42 Fed. Reg.
26951 and, if applicable, flood insurance purchase requirements of Section 102(a) of the
Flood Disaster Protection Act of 1973 (PL 93-234); 5) Assurance of project consistency with
the approved State Management program developed under the Coastal Zone Management Act
of 1972,16 USC §§ 1451 et seq.; 6) Federal Water Pollution Control Act, 33 USC §1251 et
seq.; 7) Protection of underground sources of drinking water under the Safe Drinking Water
Act of 1974, 42 USC §§ 300f-300j; 8) Protection of endangered species under the Endangered
Species Act of 1973, 16 USC §§ 1531 et seq.; 9) Conformity of federal actions to state clean
air implementation plans under the Clean Air2 ltet s195 c latedso p o40cting certain)rivers
and Scenic Rivers Act of 1968 (16 USC §§ ~•) 4801 et se
system; and 11) Lead-Based Paint Poisoning Prevention Act (42 USC §§ 9~)
prohibiting the use of lead-based paint in residential construction or rehabilitation;
p) Intergovernmental Personnel Act of 1970 (42 USC §§4278-4763) regazding personnel merit
systems for programs specified in Appendix A of the federal Office of Program
Management's standazds for a Merit System of Personnel Administration (5 CFR Part 900,
Subpart F);
q) Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Polictes
Act of 1970 (PL 91-646), relating to fair treatment of persons displaced or whose property is
acquired as a result of Federal 276aao 276a-7) Sthe Copeland~Act (40 U.S.C. § 276c and 18
r) Davis-Bacon Act (40 USC §§
USC § 874), and the Contract Work Hours and Safety Standards Act (40 USC §§ 327-333),
regazding labor standards for federally-assisted construction subagreements;
s) National Historic Preservation Act of 1966, §106 (16 USC § 470), Executi 469aleet se 93,
and the Archaeological and Historic Preservation Act of 1974 (16 USC §§ q•)
regazding historic property to the extent necessary to assist DSHS in complying with the Acts;
t) financial and compliance audits in accordance with Single Audit Act Amendments of 1996
and OMB Circulaz No. A-133, "Audits of States, Local Governments, and Non-Profit
Organizations;" and
6/5/08 Page 3 of 38
General Provisions (Core Subrecipient 2009)
Department, whether that date is prior to or after the date of any ratification by Contractor's
governing boazd.
Section 1.09 Civil Rights Policies and Complaints. Upon request, Contactor shall provide the
Health and Human Services Commission (HHSC) Civil Rights Office with copies of all Contractor's
civil rights policies and procedures. Contractor must notify HHSC's Office of Civil Rights of any
civil rights complaints received relating to performance under this Contract no more than ten (10)
calendaz days after Contractor's receipt of the claim. Notice must be directed to -
HHSC Civil Rights Office
701 W. 51st St., Mail Code W206
Austin, Texas 78751
Toll-free phone (888) 388-6332
Phone (512) 438-4313
TTY Toll-free (877) 432-7232
Fax (512) 438-5885
ARTICLE II SERVICES
Section 2.01 Education to Persons in Residential Facilities. If applicable, Contractor shall ensure
that all persons, who aze housed in Department licensed and/or funded residential facilities and who
aze twenty-two (22) yeazs of age or younger, have access to educational services as required by Tex.
Educ. Code § 29.012. Contractor shall notify the local education agency or local eazly intervention
program as prescribed by Tex. Fduc. Code § 29.012 not later than the third calendar day after the date
a person who is twenty-two (22) yeazs of age or younger is placed in Contractor's residential facility.
Section 2.02 Disaster Services.
In the event of a local, state, or federal emergency, including natural, man-made, criminal, terrorist,
and/or bioterrorism events, declazed as a state disaster by the Governor, or a federal disaster by the
appropriate federal official, Contractor may be called upon to assist DSHS in providing services, as
appropriate, in the following azeas: community evacuation; health and medical assistance; assessment
of health and medical needs; health surveillance; medical care personnel; health and medical
equipment and supplies; patient evacuation; in-hospital care and hospital facility status; food, drug,
and medical device safety; worker health and safety; mental health and substance abuse; public health
information; vector control and veterinazy services; and victim identification and mortuary services.
Disaster services shall be carried out in the manner services of the Contractor.ds of the emergency, be
cost effective, and be least intrusive on the primary
Section 2.03 Consent to Medical Care of a Minor. If Contractor provides medical, dental,
psychological or surgical treatment to a minor under this Contract, either directly or through contracts
islobtained pursuant to TexaFamtCode, Chapter 32 relating to ~onsent~to treatment of a child by ant
6/5/08 Page 5 of 38
General Provisions (Core Subrecipient 2009)
any family member or friend of the client as an interpreter for essential communications with a client
with limited English proficiency unless the client has requested that person and the use of such a
person would not compromise the effectiveness of services or violate the client's confidentiality and
the client is advised that a free interpreter is available.
ARTICLE III FUNDING
Section 3.01 Debt to State and Corporate Status. Pursuant to Tex. Gov. Code § 403.055, the
Department will not approve and the State Comptroller will not issue payment to Contractor if
Contractor is indebted to the State for any reason, including a tax delinquency. Contractor, if a
corporation, certifies by execution of this Contract that it is current and will remain current in its
payment of franchise taxes to the State of Texas or that it is exempt from payment of franchise taxes
under Texas law (Tex. Tax Code §§ 171.001 et seq., as amended). Contractor, if a corporation,
further certifies that it is and will remain in good standing with the Secretary of State's office. A
false statement regazding franchise tax or corporate status is a material breach of this Contract. If
franchise tax payments become delinquent during the Contract term, all or part of the payments under
this Contract may be withheld until Contractor's delinquent franchise tax is paid in full.
Section 3.02 Application of Payment Due. Contractor agrees that any payments due under this
Contract will be applied towazds any debt of Contractor, including but not limited to delinquent taxes
and child support that is owed to the State of Texas.
Section 3.03 Use of Funds. Contractor agrees that it shall expend Department funds only for the
provision of approved services and for reasonable and allowable expenses directly related to those
services.
Section 3.04 Use for Match Prohibited. Contractor agrees funds provided through this Contract
shall not be used for matching purposes in securing other funding unless directed or approved by the
Department in writing.
Section 3.05 Program Income. Gross income directly generated from Department funds through a
project or activity performed under a Program Attachment and/or earned only as a result of a
Program Attachment during the term of the Program Attachment aze considered program income.
Unless otherwise required under the terms of the grant funding this Contract, the addition alternative,
as provided in UGMS § - 25(8)(2), for the use of program income shall be used by Contractor to
further the program objectives of the state or federal statute under which the Program Attachment
was made, and it shall be spent on the same Program Attachment project in which it was generated.
Contractor shall identify and report this income in accordance with the Compliance and Reporting
Article of these General Provisions and the provisions of the Program Attachment(s). Contractor
shall expend program income during the Program Attachment term and may not carry forward to the
succeeding term. Program income not expended in the term in which it is earned shall be refunded to
DSHS. DSHS may base future funding levels, in part, upon Contractor's proficiency in identifying,
General Provisions (Core Subrecipient 2009) 6/5/08 Page 7 of 38
assigned to the Program Attachment to justify the need for a working capital advance. The working
capital advance must be liquidated as directed by the Department. The requirements for the
documentation justifying the need for an advance and the directions for liquidating the advance aze
found in the Contractor's Financial Procedures Manual located at
http•//www dshs state.tx.us/contracts.
Section 4.05 Financial Status Reports (FSRs). Except as otherwise provided in these General
Provisions or in the terms of the Program Attachment(s), for contracts with categorical budgets,
Contractor shall submit quarterly FSRs to Accounts Payable by the thirtieth calendaz day of the
month following the end of each quarter of the Program Attachment term for Department review and
financial assessment. The final FSR must be submitted not later than sixty (60) days following the
end of the applicable term.
Section 4.06 Third Party Payots. A third party payor is any person or entity who has the legal
responsibility for paying for all or part of the services provided, including commercial health or
liability insurance carriers, Medicaid, or other federal, state, local, and private funding sources.
Except as provided in this Contract, Contractor shall screen all clients and shall not bill the
Department for services eligible for reimbursement from third party payors. Contractor shall: (a)
enroll as a provider in Children's Health Insurance Plan and Medicaid if providing approved services
authorized under this Contract that maybe covered by those programs, and bill those plans for the
covered services; (b) provide assistance to individuals to enroll in such programs when the screening
process indicates possible eligibility for such programs; (c) allow clients that aze otherwise eligible
for Department services, but cannot pay a deductible required by a third party payor, to receive
services up to the amount of the deductible and to bill the Department for the deductible; (d) not bill
the Department for any services eligible for third party reimbursement until all appeaPs t y P ~ party
payors have been exhausted; (e) maintain appropriate documentation from the third art a or
reflecting attempts to obtain reimbursement; (f) bill all third party payors for services Prrovide thbaer
this Contract before submitting any request for reimbursement to Department; and (g) p
party billing functions at no cost to the client.
ARTICLE V TERMS AND CONDITIONS OF PAYMENT
Section 5.01 Prompt Payment. Upon receipt of a timely, undisputed invoice pursuant to this
Contract, Department will pay Contractor. Payments and reimbursements aze contingent upon a
signed Contract and will not exceed the total amount of authorized funds under this Contract.
Contractor is entitled to payment or reimbursement only if the service, work, and/or product has been
authorized by the Department and performed or provided pursuant to this Contract. If those
conditions are met, Department will make payment in accordance with the Texas prompt payment
law (Tex. Gov. Code Chapter 2251). Contractor must comply with Tex. Gov. Code Chapter 2251
regazding its prompt payment obligations to subcontractors. Payment of invoices by the Department
shall not constitute acceptance or approval of Contractor's performance, and all invoices and
Contractor's performance is subject to audit or review by the Department.
Section 5.02 Withholding Payments. Department may withhold all or part of any payments to
Contractor to offset reimbursement for any ineligible expenditures or overpayments that Contractor
General Provisions (Core Subrecipient 2009) 6/5/08 Page 9 of 38
Non-Profit OMB Circulaz OMB Circulaz wiv.~, ~'•"'
Organizations A-122 A-133 and UGMS Circular A-110 and
applicable Federal
awazding agency
For-profit
48 CFR Part 31,
Program aumt uvlvlu a..., ~rr••----
onducted by an
al
e
Organization other Contract Cost c
common le
enc
a
independent 8 Y
than a hospital and an Principles certified public
organization named in Procedures, or i
OMB Circulaz A-122 uniform cost n
accountant
accordance with
as not subject to that accounting
standazds that Governmental
Circulaz. comply with cost Auditing
principles Standards.
acceptable to the
federal or state
A chart of applicable common rules is located on the Internet at
htto //www Whitehouse eov/omb/¢rants/chart.html. OMB Circulazs will be applied with the
modifications prescribed by UGMS with effect given to whichever provision imposes the more
stringent requirement in the event of a conflict.
Section 6.02 Independent Single or program-SpeciCc Audit. If Contractor within Contractor's
fiscal yeaz expends a total amount of at least $500,000 in state funds awarded or at least $500,000 in
federal funds awazded, Contractor must have a single audit or program-specific audit in accordance
with the Office of Management and Budget (OMB) Circ. No. A-133, the Single Audit Act of 1984, P
L 98-502, 98 Stat. 2327, and the Single Audit Act Amendments of 1996, P L 104-156, 110 Stat.
1396. The $500,000 federal threshold amount includes federal funds passed through by way of state
agency awards. The HHSC Office of Inspector General (OIG) will notify the Contractor to complete
the Single Audit Determination Registration Form. If Contractor fails to complete the Single Audit
Determination Form within thirty (30) days after notification by OIG to do so, Contractor shall be
subject to DSHS sanctions and remedies for non-compliance with this Contract. The audit shall be
conducted by an independent certified public accountant and in accordance with applicable OMB
Circulazs, Government Auditing standazds, and Uniform Grant Management standazds (iJGMS)
located on the Internet at
htt ://www. overnorstate.tx.us/divisions/state rants/ uidelines/files/UGMS062004.doc. Contractor
shall procure audit services incompliance with this section, state procurement procedures, as well as
with the provisions of UGMS. Contractor, unless Contractor is a governmeaz~andrshall not use the
competitively re-procure independent single audit services every five (5) y
same lead or coordinating audit partner (having primary responsibility for the audit) to conduct the
independent audit for more than five (5) consecutive yeazs. Procurement of audit services must
comply with the procurement standazds of 45 CFR Part 74 or 92, as applicable, including obtaining
6/5/08 Page 11 of 38
General Provisions (Core Subrecipient 2009)
Safety Code § 614.017(a)(2) relating to special needs offenders, to an agency described in Tex.
the information is not allowed to(be disclosed under 45 CFR Part 164sor o~heraappl'c able aws that
Section 7.04 Security of Patient or Client Records. Contractor must maintain patient and client
records incompliance with state and federal law relating to security and retention of medical or
mental health and substance abuse patient records. Department may require Contractor to transfer
original or copies of patient and client records to Department, without the consent or authorization of
the patient or client, upon termination of this Contract or a Program Attachment to this Contract, as
applicable, or if the caze and treatment of the individual patient or client is transferred to another
entity. Prior to providing services funded under this Contract to a patient or client, Contractor shall
attempt to obtain consent from the patient or client to transfer copies of patient or client records to
Co tract nas appli able, orD flcazeo treatment is transferred to aanother DSHS-fufunded contractor.is
Section 7.05 IiIV/AIDS Model Workplace Guidelines. If providing direct client caze, services,
or progams, Contractor shall implement Department's policies based on the HN/AIDS (human
immunodeficiency virus/acquired immunodeficiency syndrome) Model Workplace Guidelines for
Businesses, State Agencies, and State Contractors, Policy No. 090.021, and Contractor shall educate
employees and clients concerning HN and its related conditions, including AIDS, in accordance with
the Tex. Health & Safety Code § 85.112-114. A link to the Model Workplace Guidelines can be
found at htt //www dshs state tx us/hivstd/policy/ndf/090021.odf.
ARTICLE VIII RECORDS RETENTION
Section 8.01 Retention. Contractor shall retain records in accordance with applicable state and
federal statutes and regulations. At a minimum, Contractor shall retain and preserve all other records,
including Financial records that az eazes after the t ormination of this ContractdeIf servicessaze funded
Contract, for a period of four (4) y ears, shall apply. Contractor
through Medicaid, the federal retention period, if more than four (4) y
shall retain all records pertaining to this Contract that aze the subject of litigation ouirements ford the
litigation has ended or all questions pertaining to the audit aze resolved. Legal req
Contractor may extend beyond the retention schedules established in this sectio 1 5 1 bacand scaolr
retain medical records in accordance with Tex. Admin. Code Title 22, Part 9> § () ( )
other applicable statutes and regulations governing medical information. Contractor shall ensure that
this provision concerning records retention is included in any subcontract it awards. If Contractor
ceases business operations, it shall ensure that records relating to this Contract azeeazs from the date d
aze accessible by the Department upon Department's request for at least four (4) y
Contractor ceases business or from the termination date of res onsible for forage of records to the
Contractor shall provide the name and address of the party p
Division Contract Management Unit assigned to the Program Attachment.
6/5/08 Page 13 of 38
General Provisions (Core Subrecipient 2009)
Nutrition Services. Contractor shall make a good faith effort to comply with child abuse reporting
guidelines and requirements in Tex. Fam. Code Chapter 261 relating to investigations of reports of
child abuse and neglect. Contractor shall develop, implement and enforce a written policy that
includes at a minimum the Department's Child Abuse Screening, Documenting, and Reporting Policy
for Contractors/Providers and train all staff on reporting requirements. Contractor shall use the
DSHS Child Abuse Reporting Form as required by the Department located at
www dshs state tx us/childabusereyortinQ. Contractor shall retain reporting documentation on site
and make it available for inspection by DSHS.
Section 10.02 Significant Incidents. Tn addition to notifying the appropriate authorities, Contractor
shall report to the Division Contract Management Unit assigned to the Program Attachment
significant incidents involving substantial disruption of program operation or potentially affecting
Department-funded clients or participants within seventy-two (72) hours of discovery.
Section 10.03 Litigation. Contractor shall notify the Division Contract Management Unit assigned
to the Program Attachment of litigation related to or affecting this Contract and to which Contractor
is a party within seven (7) calendaz days of becoming awaze of such a proceeding. This includes, but
is not limited to an action, suit or proceeding before any court or governmental body, including
environmental and civil rights matters, professional liability, and employee litigation. Notification
shall include the names of the parties, nature of the litigation and remedy sought, including amount of
damages, if any.
Section 10.04 Action Against the Contractor. Contractor shall notify the Division Contract
Management Unit assigned to the Program Attachment if Contractor has had a contract suspended or
temunated for cause by any local, state or federal department or agency or nonprofit entity within
three (3) working days of the suspension or termination. Such notification shall include the reason
for such action; the name and contact information of the local, state or federal department or agency
or entity; the date of the contract; and the contract or case reference number. If the Contractor, as an
organization, has surrendered its license or has had its license suspended or revoked by any local,
state or federal department or agency ornon-profit entity, it shall disclose this infotmation within
three (3) working days of the surrender, suspension or revocation to the Division Contract
Management Unit assigned to the Program Attachment by submitting a one page description that
includes the reason(s) for such action; the name and contact information of the local, state or federal
department or agency or entity; the date of the license action; and a license or case reference number.
Section 10.05 Insolvency. Contractor shall notify in writing the Division Contract Management
Unit assigned to the Program Attachment of Contractor's insolvency, incapacity, or outstanding
unpaid obligations to the Internal Revenue Service (IRS) or Texas Workforce Commission (TWC)
within three (3) working days of the date of determination that Contractor is insolvent or
incapacitated, or the date Contractor discovered an unpaid obligation to the IRS or TWC. Contractor
shall notify in writing the Division Contract Management Uon~nssagns of suchao on by thechment
of its plan to seek bankruptcy protection within three (3) B Y
Contractor's board of directors.
Section 10.06 Misuse of Funds. Contractor shall report to the Division Contract Management Unit
assigned to the Program Attachment and to the SAO, any knowledge of debarment, suspected fraud,
program abuse, possible illegal expenditures, unlawful activity, or violation of financial laws, rules,
6/5108 Page 15 of 38
Genera] Provisions (Core Subrecipient 2009)
e) it is in good standing with all state and/or federal agencies that have a contracting or
regulatory relationship with Contractor;
f) that no person who has an ownership or controlling interest in Contractor or who is an agent
or managing employee of Contractor has been convicted of a criminal offense related to
involvement in any program established under Medicaze, Medicaid, or a federal block grant;
g) neither it, nor its principals have within the three-yeaz period preceding this Contract, has
been convicted of or had a civil judgment rendered against them for commission of fr rivate or
criminal offence in connection with obtaining, attempting to obtain, or performing a p
public (federal, state or local) transaction or contract under a private or pubnce fixinc between
violation of federal or state antitrust statutes (including those proscribing p B
competitors, allocation of customers between competitors and bid rigging), or commission of
embezzlement, theft, forgery, bribery, falsification or destmction of records, making false
statements or false claims, tax evasion, obstruction of justice, receiving stolen property or any
other offense indicating a lack of business integrity or business honesty that seriously and
directly affects the present responsibility of Contactor or its principals;
h) neither it, nor its principals is presently indicted or otherwise criminally or civilly chazged by
a governmental entity (federal, state or local) with the commission of any of the offenses
enumerated in subsection g) of this section; and
r) more public trtansaction (federall stateuorelocal)penninatedfcr ause or defaulthas had one or
Contractor shall include the certifications in this section, without modification (except as required to
make applicable to the subcontractor of the st tements in this Article, Cont actor shall submi~ere
Contractor is unable to certify to any
explanation to the Division Contract Management Unit assigned to the Program Attachment. If
Contractor's status with respect to the items certified above changes during the term of this Contract,
Contractor shall irnmediately notify the Division Contract Management Unit assigned to the Program
Attachment.
Section 11.02 Child Support Delinquencies. As required by Tex. Fam. Code § 231.006, a child
support obligor who is more than thirty (30) calendaz days delinquent in paying child support and a
business entity in which the obligor is a sole proprietor, partner, shazeholder, or owner with an
ownership interest of at least twenty-five percent (25%) is not eligible to receive payments from state
funds under a contract to provide property, materials, or services or receive astate-funded grant or
loan. If applicable, Contractor agrees to maintain its eligibility to receive payments under this
Contract, certifies that it is not ineligible to receive the payments specified in this Contract, and
acknowledges that this Contract may be terminated and payment maybe withheld if this certification
is inaccurate.
Section 11.03 Authorization. Contractor certifies that it possesses legal authority to contract for the
services set forth in this Contract and that a resolution, motion or similaz action has been duly
adopted or passed as an official act of the Contractor's governing body, authorizing the binding of the
organization under this Contract including all understandings and assurances contained in this
Contract, and directing and authorizing the person identified as the authorized representative of the
6/5/08 Page 17 of 38
General Provisions (Core Subrecipient 2009)
for all funds and materials received from Department. Within thirty (30) days of the beginning of the
term of each Contract (including each renewal of the Contract, if any), each member of Contractor's
boazd shall sign a statement affirming his or her acknowledgement of personal accountability for
Contract funds on a form supplis of becoming a boardemembere Contractor hall marnt~n the signed
statement within thirty (30) day
form for inspection by DSHS. The responsibility of Contractor's governing boazd s; able federal e
accountability for compliance with Department Rules, policies, procedures, and app
and state laws and regulations; and correction of fiscal and program deficiencies identified through
self-evaluation and Department's monitoring processes. Further, Contractor's governing boazd shall
ensure sepazation of powers, duties, and functions of boazd members and staff. Staff members,
including the executive director, shall not serve as voting members of the Contractor's governing
boazd. No member of Contractor's governing boazd, or officer or employee of Contractor shall vote
for, confirm or act to influence the employment, compensation or change in status of any person
related within the second degree of affinity or the third degree of consanguinity (as defined in Tex.
Gov. Code Chapter 573) to the member of the governing body or the officer or any employee
authorized to employ or supervise such person. This prohibition does not prohibit the ceazsn rior to
employment of open nt or employment otf the officerm, employee, or governing body member related
the election, app
to such person in the prohibited degree. These restrictions shall also apply to the governing boaz ,
officers and employees of Contractor's subcontractors. Ignorance of any Contract provisions or other
requirements contained or referenced in this Contract shall not constitute a defense or basis for
waiving or appealing such provisions or requirements.
Section 12.02 Management and Control Systems. Contractor shall comply with all the
requirements of the Department's Contractor's Financial Procedures Manual, and any of its
subsequent amendments, which is available at the Department's web site:
}r ://www.dshs.state.tx.us/contracts. Contractor shall maintain an appropriate contract
administration system to insure that all terms, conditions, and specifications aze met. Contractor shall
develop, implement, and maintain financial management and control systems that meet or exceed the
requirements of UGMS and adhere to procedures detailed in Department's Contractor's Financial
Procedures Manual. Those requirements shall include at a minimum:
a) financial planning, including the out authorized activiuees and the adequate determination of s
and resources necessazy to cazry
costs;
b) financial management systems that include accurate accounting records that aze accessr e
and identify the source and application of funds provided under each Program Attachment of
solely allocable torthe Program Attachment nd azetraceable f omsthe tra sacrion tlo the
general ledger; and
c) effective internal and budgetary controls; comparison of actual costs to budget; detemunatron
of reasonableness, allowableness, and allocability of costs; timely and appropriate audits and
resolution of any findings; billing and co]lection policies; and a mechanism capable of billing
and making reasonable efforts to collect from clients and third parties.
6/5/08 Page 19 of 38
General Provisions (Core Subrecipien[ 2009)
that its current Cost Allocation Plan for the current yeaz is the same as that submitted to DSHS for the
previous yeaz. ht the event that the Cost Allocation Plan changes during the Contract term, Contractor
must submit a new Cost Allocation Plan to the Contract Oversight and Support Section within thirty
(30) calendaz days after the effective date of the change. Cost Allocation Plan must comply with the
guidelines provided in the Department's Contractor's Financial Procedures Manual located at
htt ://www.dshs.state.tx.us/contracts.
Section 12.09 Reporting for Unit Rate and Fee For Service Contracts. Contractor shall submit
reports concerning unit rate and fee-for-service contracts to the Department in accordance with the
requirements stated in the Department's Contractor's Financial Procedures Manual located at
htt ://www.dshs.state.tx.us/contracts.
Section 12.10 Historically Underutilized Businesses (HUBS). If Contractor was not required to
submit a HUB subcontracting plan and if subcontracting is permitted under this Program Attachment,
Contractor is encouraged to make a good faith effort to consider subcontracting with HUBS as set
forth in Tex. Gov. Code Chapter 2161 and 34 Tex. Admin. Code § 20.14 et seq. Contractors may
obtain a list of HUBS at htt //www window state tx us/orocurement/nroe/hub. If Contractor has
filed a HUB subcontracting plan, the plan is incorporated by reference to thrs Contract. If Contractor
desires to make a change in the plan, Contractor must obtain prior approval from the Department's
HUB Coordinator of the revised plan before proposed changes will be effective under this Contract.
Contractor agrees to make a good faith effort to subcontract with HUBS during the performance of
this Contract and shall report HUB subcontract activity to the Department's HUB Coordinator by the
15th day of each month for the prior month's activity, if there was any such activity, in accordance
with 34 Tex. Admin. Code § 20.16(c).
Section 12.11 Buy Texas. Contractor shall purchase products and materials produced in Texas when
the products and materials aze available at a price and time comparable to products and materials
produced outside of Texas as required by Tex. Gov. Code § 2155.4441.
Section 12.12 Contracts with Subrecipient Subcontractors. Contractor may enter into contracts
with subrecipient subcontractors unless restricted or otherwise prohibited in a specific Program
Attachment(s). Prior to entering into an agreement equaling or exceeding $100,000, Contractor shall
obtain written approval from DSHS. Contracts with subcontractors shall be in writing and include the
following:
a) name and address of all parties;
b) a detailed description of the services to be provided;
c) measurable method and rate of payment and total amount of contract;
d) cleazly defined and executable termination clause;
e) beginning and ending dates that coincide with the dates of the applicable Program
Attachment(s) or that cover a term within the beginning and ending dates of the applicable
program Attachment(s);
f) access to inspect the work and the premises on which any work is performed, in accordance
with the Access and Inspection ARicle in these General Provisions; and
g) a copy of these General Provisions an () cPpy of the Statement of Work and any other
provisions in the Program Attachment s a licable to the subcontract.
Contractor is responsible to DSHS for the performance of any subcontractor. Contractor shall
monitor subcontractors for both financial and programmatic performance and shall maintain pertinent
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General Provisions (Core Subrecipient 2009)
Section 12.18 Notice of Organizational Change. Contractor shall submit written notice to the
Division Contract Management Unit assigned to the Program Attachment within ten (10) business
days of any change to the following: Contractor s name; contact information; key personnel, officer,
duector or partner; organizational structure; legal standing; or authority to do business in Texas. A
change in Contractor's name requires an amendment to this Contract in accordance with the
Amendments section of these General Provisions.
Section 12.19 Quality Management. Contractor shall comply with quality management
requirements as dtrected by the Department.
Section 12.20 Equipment (Including Controlled Assets) purchases. Equipment means an article
of nonexpendable, tangible personal property having a useful lifetime of more than one yeaz and an
acquisition cost of $5,000 or more, and "controlled assets: ' Controlled assets include firearms
regazdless of the acquisition cost, and the following assets with an acquisition cost of $500 or more:
desktop and laptop computers, non-portable printers and copiers, emergency management equipment,
communication devices and systems, medical and laboratory equipment, and media equipment.
Contractors on a cost reimbursement payment method shall inventory all equipment. If the purchase
of equipment is approved in writing by the Department, Contractor is required to initiate the purchase
of that equipment in the first quarter of the Contractor Program Attachment term, as applicable.
Failure to initiate the purchase of equipment may result in loss of availability of funds for the
purchase of equipment. Requests to purchase previously approved equipment after the first quarter of
the Program Attachment must be submitted to the Division Contract Management Unit assigned to
the Program Attachment.
Section 12.21 Supplies. Supplies aze defined as consumable items necessary to carry out the
services under this Contract including medical supplies, drugs, janitorial supplies, office supplies,
patient educational supplies, softwaze, and any items of tangible personal property other than those
defined as equipment above.
Section 12.22 Changes to Equipment List. All items of equipment purchased with funds under this
Contract shall be itemized in Contractor's equipmenuiisment listlin the exe sited Co tract must be the
executed Contract. Any changes to the approved eq p
approved in writing by Department prior to purchase of equipment. Contractor shall submit to the
Division Contract Management Unit assigned to the Program Attachment, a written description .
including complete product specifications and need justification prior to purchasing any item of
unapproved equipment. If approved, Department will acknowledge its approval by means of a
written amendment or by written acceptance of Contractor's Contract Revision Request, as
appropriate.
Section 12.23 Property Inventory and Protection of Assets. Contractor shall maintain a
nonexpendable personal property (equipment and controlled assets) inventory and submit an annual
cumulative report to the Department's Contract Oversight and Support Section, Mai] Code 1326, P.O.
Box 149347 Austin, Texas 78714-9347, no later than October 15th of each yeaz. The form for this
report (Form GC-11) is located on the DSHS website at
htt ://www.dshs.state.tx.us/contracts/forms.shtm. Contractor shall administer a program of
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General Provisions (Core Subrecipient 2009)
ARTICLE XIII GENERAL TERMS
Section 13.01 Assignment. Contractor shall not transfer, assign, or sell its interest, in whole or in
part, in this Contract, or in any equipment purchased with funds from this Contract, without the prior
written consent of the Department.
Section 13.02 Lobbying. Contractor shall comply with Tex. Gov Code § 556.0055, which prohibits
contractors who receive state funds from using those funds to pay lob bo nfor influenci S oher,
Contractor shall not use funds paid under this Contract to pay any p
attempting to influence an officer or employee of any federal or state agency, a member of Congress,
an officer or employee of Congress, or an employee of a member of Congress in connection with the
awazding of any contract or the extension, continuation, renewal, amendment, or modification of any
contract (31 USCA § 1352, as amended, and UGMS). if at any time this Contract exceeds $100,000
of federal funds, Contractor shall file with the Division Contract Management Unit assigned to the
Program Attachment a declazation containing the name of any registrant under the Lobbying
Disclosure Act of 1995 who has made lobbying contacts on behalf of Contractor in connection with
this Contract, a certification that none of the funds provided by Department have been or will be used
for payment to lobbyists, and disclosure of the names of any and all registered lobbyists with whom
Contractor has an agreement. Contractor shall file the declazation, certification, and disclosure at the
time of application for this Contract; upon execution of this Contract unless Contractor previously
filed a declazation, certification, or disclosure form in connection with the awazd; and at the end of
each calendaz quarter in which there occurs any event that materially affects the accuracy of the
information contained in any declazation, certification, or disclosure previously filed. Contractor shall
require any person who requests or receives a subcontract to file the same declazation, certification,
and disclosure with the Division Contract Management Unit assigned to the Program Attachment
Contractor shall also comply, as applicable, with the lobbying restrictions and requirements in OMB
Circulazs A-122 Attachment B paragraph 25; A-87 Attachment B section 27; A-110 section_.27 and
A-21 pazagraphs 17 and 24. Contractor shall include this provision in any subcontracts.
Section 13.03 Conflict of Interest. Contractor represents to the Depaztment that it does not have nor
shall it knowingly acquire any financial or other interest that would conflict in any manner with the
performance of its obligations under this Contract. Potential conflicts of interest include, but are not
limited to, an existing or potential business or personal relationship between Contractor, its principal
(or a member of the principal's immediate family), or any affiliate or subcontractor and Department
or HHSC, their commissioners, officers or employees, or any other entity or person involved in any
way in any project that is the subject of this Contract. Contractor shall establish safeguazds to prohibit
employees from using their positions for a purpose that constitutes or presents the appeazance of
personal or organizational conflict of interest or personal gain.
Section 13.04 Transactions Between Related Parties. Contractor shall identify and report to
DSHS any transactions between Contractor and a related party that is part of the work that the
Department is purchasing under this Contract before entering into the transaction or immediately
upon discovery. Contractor shall submit to the Division Contract Management Unit assigned to the
Program Attachment the name, address and telephone nWmbeeoff rmeunderahi ContractthAre aced
related to the Contractor and the work the related party P
6/5/08 Page 25 of 38
General Provisions (Core Subrecipient 2009)
any rights of copyright, service or trade mazks or patents to which a grantee, subgrantee or a
Contractor purchases ownership with contract Funds.
e) If the results of the contract performance aze subject to copyright law, the Contractor cannot
publish those results without prior review and approval of DSHS. Contractor shall submit
requests for review and approval to the Division Contract Management Unit assigned to the
Program Attachment.
Section 13.06 Other Intangible Property. At the conclusion of the contractual relationship
between Department and the Contractor, for any reason, Department shall have the sole ownership
rights and interest in all non-copyrightable intangible property that was developed, produced or
obtained by Contractor as a specific requirement under this Contract or under any grant that funds
this Contract, such as domain names, URLs, etc. Contractor shall cooperate with Department and
perform all actions necessary to transfer ownership of such property to the Department or its
designee, or otherwise affirm Department's ownership rights and interest in such property. This
provision shall survive the termination or expiration of this Contract.
Section 13.07 Severability and Ambiguity. If any Provision of this Contract is construed to be
illegal or invalid, the illegal or invalid provision will be deemed stricken and deleted to the same
extent and effect as if never incorporated, but all other provisions will continue. Parties represent and
agree that the language contained in this Contract is to be construed as jointly drafted, proposed and
accepted.
Section 13.08 Legal Notice. Any notice required or permitted to be given by the provisions of this
Contract shall be deemed to have been received by a Party on the third business day after the date on
which it was mailed to the Party at the address first given above (or at such other address as the Party
shall specify to the other Party in writing) or, if sent by certified mail, on the date of receipt.
Section 13.09 Successors. This Contract shall be binding upon the Parties and their successors and
assignees, except as expressly provided in this Contract.
Section 13.10 Headings. The articles and section headings used in this Contract aze for convenience
of reference only and shall not be construed in any way to define, limit or describe the scope or intent
of any provisions.
Section 13.11 Parties. The Parties represent to each other that they are entities fully familiaz with
transactions of the kind reflected by this document, and aze capable of understanding the terminology
and meaning of its terms and conditions and of obtaining independent legal advice pertaining to this
Contract.
Section 13.12 Survivability of Terms. Termination or expiration of this Contract or a Program
Attachment for any reason shall not release either Party from any liabilities or obligations set forth in
this Contract that (a) the Parties have expressly agreed shall survive any such termination or
expiration, or (b) remain to be performed or (c) by their nature would be intended to be applicable
following any such termination or expiration.
Section 13.13 Direct Operation. The Department may temporarily assume operations of a
Contractor's program or programs funded under this Contract when the continued operation of the
6/5/08 Page 27 of 38
General Provisions (Core Subrecipient 2009)
a) cumulative budget line item transfers among duect cost categories, other than the equipment
category, that exceed 10% of Program Attachments of $100,000 or more, provided that the
total budget amount is unchanged;
b) line item transfer to other categories of funds for direct payment to trainees for training
allowances;
c) change in clinic hours or location;
d) change in equipment list substituting an iurchase of XYZ brandtcomputer instead of app orvedt
on the approved budget, (For example, p
ABC brand computer with essentially identical features as the XYZ computer);
e) changes in the equipment category of a previously approved equipment budget (other than
acquisition of additional equipment, which requires an amendment to this Contract);
f) changes specified in applicable OMB Circulaz cost principles as requiring prior approval,
regazdless of dollaz threshold (e.g., foreign travel expenses, overtime premiums, membership
fees); and
g) changes to community sites, independent school districts or schools, in substance abuse
Program Attachments.
In order to request a revision of any of the enumerated provisions, Contractor shall obtain a Contract
Revision Request form from the DSHS website and complete the form as directed by the Department.
Two copies of the completed form must be signed by Contractor's representative who is authorized to
sign contracts on behalf of Contractor, and both original, signed forms must be submitted to the
Division Contract Management Unit assigned to the Program Attachment. Any approved revision
will not be effective unless signed by the DSHS Director of Client Services Contracting Unit. A
sepazate Contractor Revision Request is required for each Program Attachment to be revised.
Circumstances of a requested contract revision may indicate the need for an amendment described in
the Amendment section of this Article rather than a contract revision under this section.
Section 13.18 Immunity Not Waived. THE PARTIES EXPRESSLY AGREE THAT NO
PROVISION OF THIS CONTRACT IS IN ANY WAY INTENDED TO CONSTITUTE A
OR FROM LIABILTTY THAT DEPARTMENT OR THE STATE OF TEXAS MAY HAVE BY IT
OPERATION OF LAW.
Section 13.19 Hold Harmless and Indemnification. Contractor, as an independent contractor,
agrees to hold Department, the State of Texas, individual state employees and officers, and the
federal government harmless and to indemnify them from any and all liability, suits, claims, losses,
damages and judgments, and to pay all costs, fees, and damages to the extent that such costs, fees,
and damages arise from performance or nonperformance of Contractor, its employees,
subcontractors, joint venture participants or agents under this Contract.
Section 13.20 Waiver. Acceptance by either Party of partial performance or failure to complain of
any action, non-action or default under this Contract shall not constitute a waiver of either Party's
rights under this Contract.
Section 13.21 Technology Accessibility. If performance under this Contract includes the
development, modification or maintenance of a website or other electronic information resources for
6/5/08 Page 29 of 38
General Provisions (Core Subrecipient 2009)
services or goods. HHSC OIG may investigate, audit and impose or recommend imposition of
sanctions to Department for any breach of this Contract and may monitor Contractor for financial
compliance. The Department may impose one or more remedies or sanctions for each item of
noncompliance and will determine sanctions on a case-by-case basis. Contractor is responsible for
complying with all of the terms of this Contract. The listing of or use of one or more of the remedies
or sanctions listed below does not relieve Contractor of any obligations under this Contract. A state
or federal statute, rule or regulation, or federal guideline will prevail over the provisions of this
Article unless the statute, rule, regulation, or guideline can be read together with the provision(s) of
this Article to give effect to both. If the Contractor breaches this Contract by failing to comply with
one or more of the terms of this Contract, including but not limited to compliance with applicable
statutes, rules or regulations, the Department may take one or more of the actions listed below:
a) terminate this Contract or a Program Attachment of this Contract as it relates to a specific
program type. in the case of termination, the Department will inform Contractor of the
termination no less than thirty-one (31) calendaz days before the effective date of the
termination in a notice of termination. The notice of termination will state the effective date
of the termination, the reasons for the termination, and, if applicable, alert the Contractor of
the opportunity to request a hearing on the termination pursuant to Tex. Gov. Code Chapter
2105 regazding administration of Block Grants. The Contractor agrees that it shall not make
any claim for payment or reimbursement for services provided from the effective date of
termination;
b) suspend all or part of this Contract. Suspension is, depending on the context, either (1) t e
temporary withdrawal of Contractor's authority to obligate funds pending corrective action by
Contractor or its subcontractor(s) or pending a decision to terminate or amend this Contract,
or (2) an action taken by a suspending official in accordance with Department rules to
immediately exclude a person from participating in contract transactions for a period of time,
pending completion of an investigation and such legal or debarment proceedings as may
ensue. Contractor may not bill DSHS for services performed during suspension, and
Contractor's costs resulting from obligations incurred by Contractor during a suspension aze
not allowable unless expressly authorized by the notice of suspension;
c) deny additional or future contracts or renewals with Contractor;
d) reduce funding if the Contractor fails to provide services or goods consistent with
perfotmance expectations described in this Contract;
e) disallow costs and credit for matching funds, if any, for all or part of the activities or action
not in compliance;
f) temporarily withhold cash payments. Temporarily withholding cash payments means the
temporazy withholding of a working capital advance, if applicable, °endin breso utiotn of
payments to Contractor for proper chazges or obligations incurred, p g
issues of noncompliance with conditions of this Contract or indebtedness to the United States
or to the State of Texas;
g) permanently withhold cash payments. Permanent withholding of cash payment means that
Department retains funds billed by Contractor for (1) unallowable, undocumented, disputed,
inaccurate, improper, or erroneous billings; (2) material failure to comply with Contract
provisions; or (3) indebtedness to the United States or to the State of Texas;
6/5/08 Page 31 of 38
General Provisions (Core Subrecipient 2009)
reconsideration of the remedies and sanctions imposed. Other than in the case of repayment or
recoupment, Contractor is required to file, within fifteen (15) calendaz days of receipt of notice, a
written response to Department acknowledging receipt of such notice. If requested by the
Department, the written response shall state how Contractor shall correct the noncompliance or
demonstrate in writing that the findings on which the remedies or sanction(s) aze based aze either
invalid or do not waaant the remedies or sanction(s). If Department determines that a remedy or
sanction is warranted, unless the remedy or sanction is subject to review under a federal or state
statute, regulation, rule, or guideline, Department's decision is final. Department shall provide written
notice to Contractor of Department's decision. If required by the Department, Contractor shall take
corrective action. If DSHS determines that repayment is warranted, DSHS will issue a demand letter
to Contractor for repayment. If full repayment is not received within the time limit stated in the
demand letter, and if recoupment is available, DSHS will recoup the amount due to DSHS from funds
otherwise due to Contractor.
Section 14.04 Emergency Action. In an emergency, Department may immediately terminate or
suspend all or part of this Contract, temporarily or permanently withhold cash payments, deny
contract renewal or future contract awazds, or delay contract execution by delivering written notice to
Contractor, by any verifiable method, stating the reason for the emergency action. An "emergency"
is defined as the following:
a) Contractor is noncompliant and the noncompliance has a direct adverse impact on the public
or client health, welfaze or safety. The direct adverse impact maybe programmatic or
financial and may include failing to provide services, providing inadequate services,
providing unnecessary services, or utilizing resources so that the public or clients do not
receive the benefits contemplated by the scope of work or performance measures; or
b) Contractor is expending funds inappropriately.
Whether Contractor's conduct or noncompliance is an emergency will be determined by Department
on a case-by-case basis and will be based upon the nature of the noncompliance or conduct.
ARTICLE XV CLAIMS AGAINST THE DEPARTMENT
Section 15.01 Breach of Contract Claim. The process for a breach of contract claim against the
Department provided for in Tex. Gov. Code Chapter 2260 and implemented in Department Rules §§
1.431-1.447 shall be used by DSHS and Contractor to attempt to resolve any breach of contract claim
against DSHS.
Section 15.02 Notice. Contractor's claims for breach of this Contract that the Parties cannot resolve
in the ordinary course of business shall be submitted to the negotiation process provided in Tex. Gov
Code Chapter 2260, subchapter B. To initiate the process, Contractor shall submit written notice, as
required by subchapter B, to DSHS's Office of General Counsel. The notice shall specifically state
that the provisions of Chapter 2260, subchapter B, are being invoked. A copy of the notice shall also
to the filingaof atconte sed casetproceeding underdTexn Gov Code Chapte B 260,csubchapterrC edent
6/5/08 Page 33 of 38
General Provisions (Core Subrecipient 2009)
competing or noncompeting continuation, renewal, extension, or supplemental awazd; or (4) voiding
of a contract upon determination that the awazd was obtained fraudulently, or was otherwise illegal or
invalid from inception.
Section 16.04 Termination Without Cause.
a) Either Party may terminate this Contractor a Program Attachment, as applicable, with at least
thirty (30) calendaz days prior written notice to the other Party, except that if Contractor seeks
to terminate a Contract or Program Attachment that involves residential client services,
Contractor must give the Department at least ninety (90) calendaz days prior written notice
and must submit a transition plan to ensure client services are not disrupted.
b) The Parties may terminate this Contract or a Program Attachment by mutual agreement.
c) Either Party may terminate this Contract or a Program Attachment with at least thirty (30)
calendaz days prior written notice to the other Party in the event funds become unavailable
through lack of appropriations, budget cuts, transfer of funds between programs or health and
human services agencies, amendments to the Appropriations Act, health and human services
consolidations, or any disruption of current appropriated funding for this Contract or Program
Attachment.
d) Department may temunate this Contract or a Program Attachment immediately when, in e
sole determination of Department, termination is in the best interest of the State of Texas.
Section 16.05 Termination For Cause. Either Party may terminate for material breach of this
Contract with at least thirty (30) calendaz days written notice to the other Party. Department may
terminate this Contract, in whole or in part, for breach of contract or for any other conduct that
jeopardizes the Contract objectives, by giving at least thirty (30) calendaz days written notice to
Contractor. Such conduct may include one or more of the following:
a) a court of competent jurisdiction Finds that Con ublic authoritlehaving juri dictionaws,
ordinances, rules, regulations or orders of any p Y
b) its surbcontractor~o conmmunicate with Departtent as necessary for the performance of this
Contract;
c) Contractor breaches a standazd of confidentiality with respect to the services provided un er
this Contract;
d) Department determines that Contractor is without sufficient personnel or resources to pe orm
under this Contract or that Contractor is otherwise unable or unwilling to fulfill any of its
requirements under this Contract or exercise adequate control over expenditures or assets;
e) Department determines that Contractor, its agent or another representative offered or gave a
gratuity (e.g., entertainment or gift) to an official or employee of DSHS or HHSC for the
purpose of obtaining a contract or favorable treatment;
f) Department determines that this Contract includes financial participation by a person who
received compensation from DSHS to pazticipate in developing, drafting or preparing the
specifications, requirements or statement(s) of work or Solicitation Document on which this
Contract is based in violation of Tex. Gov. Code § 2155.004;
g) Contractor appeazs to be financially unstable. Indicators of financial instability may include
one or more of the following:
1) Contractor fails to make payments;
2) Contractor makes an assignment for the benefit of its creditors;
6/5/08 Page 35 of 38
General Provisions (Core Subrecipient 2009)
ternnated for cause is not eligible for expansion of current contracts, if any, or new contracts or
renewals until the Department has determined that Contractor has satisfactorily resolved the issues
underlying the suspension or termination. Additionally, if this Contract is found to be void, any
amount paid is subject to refund.
Section 17.03 Appeals Rights. Pursuant to Tex. Gov. Code § 2105.302, after receiving notice from
the Department of ternnation of a contract with DSHS funded by block grant funds, Contractor may
request an administrative hearing under Tex. Gov. Code Chapter 2001.
ARTICLE XVIII CLOSEOUT AND CONTRACT RECONCILIATION
Section 18.01 Cessation of Services At Closeout. Upon expiration of this Contract or Program
Attachment, as applicable, (and any renewals of this Contract or Program Attachment) on its own
terms, Contractor shall cease services under this Contract or Program Attachment and shall cooperate
with DSHS to the fullest extent possible to ensure the orderly and safe transfer of responsibilities
under this Contract to DSHS or other entity designated by DSHS. Upon receiving notice of Contract
or Program Attachment termination ornon-renewal, the Contractor agrees to immediately begin to
transition recipients of services to alternative service providers, as needed. Contractor also agrees to
completely cease providing services under this Contract or Program Attachment by the date specified
in the termination ornon-renewal notice. Contractor shall not bill DSHS for services performed after
termination or expiration of this Contract or Program Attachment, or incur any additional expenses
once this Contract or Program Attachment is terminated or has expired. Upon termination, expiration
ornon-renewal of this Contract or a Program Attachment, Contractor shall immediately initiate
Closeout activities described in this Article.
Section 18.02 Administrative Offset. The Department shall have the right to administratively offset
amounts owed by Contractor against billings.
Section 18.03 Deadline for Closeout. Contractor shall submit all financial, performance, and other
Closeout reports required under this Contract within sixty (60) calendar days after the Contract or
Program Attachment end date. Unless otherwise provided under the Final Billing Submission section
of the Payment Methods and Restrictions Article, the Department is not liable for any claims that aze
not received within sixty (60) calendaz days after the Contract or Program Attachment end date.
Section 18.04 Payment of Refunds. Any funds paid to the Contractor in excess of the amount to
which the Contractor is finally determined to be entitled under the terms of this Contract constitute a
debt to the Department and will result in a refund due. Contractor shall pay any refund amount due
within the time period established by the Department.
Section 18.05 Disallowances and Adjustments. The Closeout of this Contract or Program
a later audit or other[ ~viewtor he Contractor'sgobligationlto rreturn any funds dueuaaa~esult of lateof
refunds, corrections, or other transactions.
Section 18.06 Contract Reconciliation. If Contractor is required to annually reconcile multi-year
contracts, Contractor, within sixty (60) calendaz days after the end of each yeaz of this Contract, shall
6/5/08 Page 37 of 38
General Provisions (Core Subrecipient 2009)
CONTRACT NO.2009-028291-
PROGRAM ATTACHMENT NO. 001
PURCHASE ORDER NO. 0000340813
CONTRACTOR: CORPUS CHRISTI-NUECES COUNTY PUBLIC HEALTH
DISTRICT (CITY)
DSHS PROGRAM: IMMUNIZATION BRANCH -LOCALS
TERM: 09/01/2008 THRU: 08/31/2009
SECTION I. STATEMENT OF WORK:
Contractor shall implement an immunization program for children, adolescents, and
adults, with special emphasis on accelerating interventions to improve the immunization
coverage of children two (2) yeazs of age or younger (up to 35 months of age).
Contractor shall incorporate traditional and non-traditional systematic approaches
designed to eliminate barriers, expand immunization capacity, and establish uniform
operating policies, as described herein.
Contractor shall plan and implement community-based activities to accomplish the
required tasks as specified in the final, approved work plan (Exhibit A) and according to
guidelines specified in the DSHS Immunization Contractors Guide for Local Health
Departments (located at
http://www.dshs.state.tx.us/immunize/providers.shtm#resources).
Contractor shall be enrolled as a provider in the Texas Vaccines for Children Program
(TVFC) by the effective date of this program attachment, and must adhere to the TVFC
Operations Manual and associated TVFC policy guidelines provided by DSHS (located at
http://www.dshs.state.tx.us/immunize/tvfc/tvfc manual.shtm). Contractor shall comply
with written policies and procedures provided by DSHS in managing vaccines supplied
through the TVFC program, including guidelines for proper storage and handling of
vaccines and for safeguazding vaccine in the event of natural disaster.
Contractor shall report all reportable conditions as specified in 25 Texas Administrative
Code (TAC) Part I §§97.1-97.6 and §§97.101-97.102, and as otherwise required by law.
Contractor shall report all vaccine adverse event occurrences in accordance with the 1986
National Childhood Vaccine Injury Act (NCVIA) 42 U.S.C. § 300aa-25 (located at
http://vaers.hhs.gov/default.htm).
Contractor shall inform and educate the public about vaccines and vaccine-preventable
diseases, as described in the DSHS Immunization Local Health Deparhnent (LHD)
Contractor's Guide.
ATTACHMENT -Page 1
Contractor shall work to promote a health care workforce within the Local Health
Department's service area (including Contractor's staff) that is knowledgeable about
vaccines, vaccine safety, vaccine-preventable diseases, and delivery of immunization
services.
Contractor shall implement DSHS's new vaccine management system, the
Pharmacy Inventory Control System (PIGS), as the system becomes available
throughout the state. Implementation will include using PIGS in Contractor's
clinics, promoting the use of the system in non-health department TVFC
provider offices, and performing updates to the system on behalf of TVFC
provider offices that submit monthly doses administered and vaccine
accounting reports in hardcopy. Contractors shall notify providers of changes
to PIGS ,and present updates and training on PIGS to providers, as requested
by DSHS ,when PIGS is implemented within the Contractor's service area.
Contractor shall not charge a fee for vaccines supplied through the TVFC program. All
TVFC-supplied vaccines shall be used solely for purposes of this Program Attachment
and shall not be sold.
In accordance with 25 TAC §1.91, Contractor shall not collect vaccine administration
fees from Medicaid and Children's Health Insurance Program (CHIP) recipients. Vaccine
administration fees collected from non-Medicaid patients shall not exceed those
established in Section Two, Part Four of the TVFC Operations Manual. Fee schedules
shall not be based on vaccine type, formulation, or dose in series.
Contractor shall not deny vaccinations to recipients because they do not reside within
Contractor's jurisdiction or because of an inability to pay an administration fee.
All equipment used by Contractor which is provided by DSHS shall be accounted for as
public property. The DSHS Program will investigate equipment loss, destruction, or
other waste and may require (at its discretion) Contractor to replace or reimburse the
DSHS Program. This provision does not waive any other remedies legally available to
DSHS regarding contract breaches.
Contractor shall comply with all applicable federal and state regulations and statutes,
including but not limited to:
• Human Resources Code §42.043, VTCA;
• Education Code §§38.001-38.002, VTCA;
• Health and Safety Code §§12.032, 81.023 and 161.001-161.009, VTCA;
• 25 TAC Chapter 97;
• 25 TAG, Chapter 96;
• 25 TAG, Chapter 100;
• 42 USC §§247b and 300 as-25; and
• Omnibus Budget Reconciliation Act of 1993, 26 USC §4980B.
ATTACHMENT -Page 2
Contractor shall comply with current applicable state and federal standards, policies and
guidelines, including but not limited to DSHS's Standards for Public Health Clinic
Services, revised August 31, 2004 (located at
http://www.dshs.state.tx.us/qmb/default. shtm#public).
Contractor shall be responsible for conducting outreach regarding vaccinations for
children 19 through 35 months of age in the Contractor's jurisdiction, who are included
on the list that will be distributed to Contractor by DSHS at the start of each tri-annual
reporting period (September 1, 2008, January 1, 2009, and May 1, 2009).
Contractor shall complete all required activities listed in the final, approved work plan, at
attached Exhibit A.
SECTION II. PERFORMANCE MEASURES:
The following performance measure(s) will be used, in part, to assess Contractor's
effectiveness in providing the services described in this Program Attachment, without
waiving the enforceability of any of the teens of the Contract:
• LHDs shall investigate and document, in accordance with DSHS Texas Vaccine-
Preventable Disease Surveillance Guidelines (located at
http://www.dshs.state.tx.us/idcu/health/vaccine~reventable_diseases/resources/v
pd_guide.pdf) and NBS Data Entry Guidelines, 100% of suspected reportable
vaccine-preventable disease cases within thirty (30) days of notification.
• LHDs shall complete 100% of the follow-up activities, designated by DSHS, for
TVFC provider quality assurance site visits assigned by DSHS.
• LHDs shall contact and provide case management to 100% of the number of
hepatitis B surface antigen-positive pregnant women identified.
• LHDs shall contact 100% or 400 per FTE (whichever is fewer) families of
children who aze not up-to-date on their immunizations according to the
ImmTrac-generated list provided to the LHD by DSHS at the beginning of each
reporting period.
• LHDs shall review 100% of monthly biological reports, vaccine order forms
(when applicable), and temperature logs for accuracy to ensure the vaccine supply
is within established maximum stock levels.
• LHDs shall complete 100% of child-caze facility and Head Start center
assessments, in accordance with the Immunization Population Assessment
Manual, as assigned by DSHS.
ATTACHMENT -Page 3
• LHDs shall complete 100% of public and private school assessments,
retrospective surveys, and validation surveys, in accordance with the
Immunization Population Assessment Manual, as assigned by DSHS.
Contractor shall utilize the AFDC (Assessment, Feedback, Incentives, and eXchange)
methodology, found in the Immunization Quality Assurance Tool Resource Manual,
(located at http://www.dshsstate.tx.us/immunize/docs/OA site visit.ndf) to conduct
quality assurance site-visits for all sub-contracted entities and non-local health
deparhnent Women, Infant and Children (WIC) clinics. Assessment shall be done
using the DSHS Immunization Quality Assurance Site Visit tool provided by DSHS
and the Comprehensive Clinic Assessment Software Application (Co-CASA), as
specified by the DSHS Program. Contractor shall submit assessment results to the
designated DSHS Regional Immunization Program manager within two (2) weeks
after completion.
Contractor is required to complete and submit the following tri-annual reports, utilizing a
format provided by the DSHS Program:
Re ort T e Re ortin Period Re ort Due Date
Pro aromatic 9/1/08 - 12/31/08 1/30/09
Pro aromatic 1/1/09 - 4/30/09 5/30/09
Programmatic 5/1/09 - 8/31/09 09/30/09
Tri-annual reports should be submitted electronically to
immunizationcontracts@dshs.state.tx.us, the Contract Management Unit in Austin,
Texas.
Contractor must receive written approval from DSHS before varying from applicable
policies, procedures, protocols, and/or work plans, and must update and disseminate its
implementation documentation to its staff involved in activities under this contract within
forty-eight (48) hours of making approved changes.
SECTION III. SOLICITATION DOCUMENT:
NA
SECTION N. RENEWALS:
DSHS may renew the Program Attachment for up to four (4) twelve month terms at
DSHS's sole discretion.
ATTACHMENT -Page 4
SECTION V. PAYMENT METHOD:
Cost Reimbursement
Funding is further detailed in the attached Categorical Budget and, if applicable,
Equipment List.
SECTION VI. BILLING INSTRUCTIONS:
Contractor shall request payment using the State of Texas Purchase Voucher (Form B-13)
and acceptable supporting documentation for reimbursement of the required
services/deliverables. Vouchers and supporting documentation should be mailed or
submitted by fax or electronic mail to the addresses/number below.
Department of State Health Services
Claims Processing Unit
1100 West 49`h Street
P. 0. Box 149347
Austin, Texas 78714-9347
The fax number for submitting State of Texas Purchase Voucher (Form B-13) to the
Claims Processing Unit is (512) 458-7442. The email address is
invoicesna,dshs.state.tx.us.
SECTION VII. SPECIAL PROVISIONS:
General Provision, Funding Article, Use of Funds Section, is revised to include:
Funds shall not be used for purchase of vaccines, inpatient caze, construction of
facilities, or debt retirement.
Travel expenses shall be reimbursed according to Contractor's written travel policy,
as submitted and approved with Contractor's FY09 Application for Immunization
Funds. If no written travel policy was submitted, or if the submitted policy is not
approved by DSHS, travel expenses shall be reimbursed according to current state
travel regulations located at http://www.window.state.tx.us/comptroUtexastra.html.
For immunization activities performed under this Program Attachment, General
Provisions, General Business Operations of Contractor Article, Overtime
Compensation Section, is replaced with the following paragraphs:
Contractor is authorized to pay employees who are not exempt under the Fair
Labor Standazds Act (FLSA), 29 USC, Chapter 8, §201 et seq., for overtime or
compensatory time at the rate of time and one-half per FLSA.
ATTACHMENT -Page 5
Contractor is authorized to pay employees who aze exempt under FLSA on a
straight time basis for work performed on a holiday or for regular compensatory
time hours when the taking of regulaz compensatory time off would be disruptive
to normal business operations.
Authorization for payment under this provision is limited to work directly related
to immunization activities and shall be in accordance with the amount budgeted in
this contract Attachment. Contractor shall document proper authorization or
approval for any work performed by exempt or non-exempt employees in excess
of forty (40) hours per work week.
SECTION VIII. BUDGET:
SOURCE OF FUNDS: CFDA #93.268 and STATE
ATTACHMENT -Page 6
2009-028291-001
Categorical Budget:
P~RS:~PI~I~L ' $iso,i92.o0
FRINGE BENEFITS $40,453.00
7RI~V~L
.: "~ v ': $7662:b0
a . ,.
EQUIPMENT $0.00
~UT~RLI~S: $4,40.00
CONTRACTUAL $0.00
C!~H~R $8ssp.ao
TOTAL DIRECT CHARGES $241,637.00
' ; II~DI,f~~CT Cl)ARF3ES $d.00
TOTAL $241,637.00
raH~,>~HgE2E ~z4i637.00
CONTRACTOR SHARE $52,468.00
OTHER NIAT~W $p.p0
Total reimbursements will not exceed $241,637.00
Financial status reports are due: 12/30/2008, 03/30/2009, 06/30/2009, 10/30/2009
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS. GRANTS. LOANS AND COOPERATIVE
AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to
any person for influencing or attempting to influence an officer or an employee of any agency, a
member of Congress, an officer or employee of Congress, or an employee of a member of Congress in
connection with the awazding of any federal contract, the making of any federal grant, [he making of
any federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of Congress,
an officer or employee of Congress, or an employee of a member of Congress in connection with this
federal connact, grant. loan, or cooperative agreement, the undersigned shall complete and submit
Standazd Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants,
loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less that $10,000 and not more than $100,000 for each
such failure.
i
/w
Sig
Print N e of Authorized Individual
y/~/aa
Date irk
2009-028291
Application or Contract Number
CORPUS CHRISTI-NUECES COUNTY
PUBLIC HEALTH DISTRICT (CITY)
Organization Name
fFRhIAFJ00 CHAp--~'_"""~% ~~ V ~~~'°~;
G`^
CSCU # EF29-12374 -Revised 08.10.07
Exhibit A
WORK PLAN
Contractors are required to perform all activities of the annual Work Plan in compliance with all
documents referenced in this Work Plan.
1. PROGRAM PLANNING AND EVALUATION
General Requirement lA: Implement a comprehensive immunization program. Activities under this
requirement shall be conducted in accordance with the DSHS Immunization Contractors Guide for Local
Health Departments.
Activities lA:
• Adhere to Standards for Child and Adolescent Immunization Practices and Standards for Adult
Immunization Practices found at:
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/H/standards-pediatric.pdf and
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/H/standazds-adult.pdf.
• Maintain staffing levels to meet required activities of the contract.
• Lapse no more than 5% of total funded amount of the contract.
• Submit required tri-annual reports by January 30, May 30, and October 15 of each contract term.
• Maintain current policies in compliance with the DSHS Immunization Contractors Guide for Local
Health Departments and have them available to Contractor's staff.
2. VACCINE MANAGEMENT
(http://www.dshs.state.tx.us/immunize/tuft/tvfc_manual.shtm)
General Requirement 2A: Ensure that expired, wasted, and unaccounted-for vaccines do not exceed 5%
in Contractor clinics. Activities under this requirement shall be conducted in accordance with the DSHS
Immunization Contractors Guide for Local Health Departments and TVFC Operations Manual.
Activity 2A:
• Maintain storage and handling polices and procedures according to the TVFC Operations Manual.
General Requirement 2B: Assist all other TVFC providers in local jurisdiction with maintaining
appropriate vaccine stock levels. Activities under this requirement shall be conducted in accordance with
the DSHS Immunization Contractors Guide for Local Health Departments and TVFC Operations Manual.
3.
Activities 2B:
Evaluate maximum vaccine stock levels twice a year in all TVFC provider clinics under Contractor
jurisdiction and assess providers' inventories during site visits.
Review vaccine orders, monthly biological reports, and monthly temperature logs for accuracy and to
ensure that the vaccine supply requested is within established maximum stock utilizing the Pharmacy
Inventory Control System (PIGS) as it becomes available.
(http://www.dshs.state.tx.us/immunize/providers.shtm and
http://dshs.state.tx.us/immunize/immtrac/default.shtm)
General Requirement 3A: Effectively utilize ImmTrac (the DSHS on-line immunization registry) in
Contractor clinics. Activities under this requirement shall be conducted in accordance with the DSHS
Immunization Contractors Guide for Local Health Departments.
EXHIBIT -Page
Activities 3A:
• Search for the child's immunization history at every client encounter,
• Review the client's record for vaccines due and overdue according to the CDC Recommended
Schedule at http://www.cdc.gov/vaccineslrecs/schedules/child-schedule.htm#printable.
• Report to ImmTrac all immunizations administered in Contractor clinics, either directly into
ImmTrac online or through TWICES.
• Update demographic information as needed.
• Follow recommended guidelines for obtaining and submitting ImmTrac consent forms according to
the instructions found at http://www.dshs.state.tx.us/immunize/dots/consent_guidelines.pdf and
verify that a child does not already have a record in ImmTrac prior to sending consent forms to
DSHS Austin.
• Implement changes to the consent process as directed by DSHS.
• Offer updated Immunization History Report to the child's parent or guardian at every client
encounter.
• At every client encounter, compare all immunization histories (ImmTrac, TWICES, validated
parent-held records, clinic medical record) and enter into ImmTrac or TWICES any historical
immunizations not in ImmTrac.
General Requirement 3B: Work in good faith, and as described herein, to increase the number of children
less than six years of age who participate in ImmTrac by 5%. Activities under this requirement shall be
conducted in accordance with the DSHS Immunization Contractors Guide for Local Health Departments.
Activity 3B:
• Verbally, and with DSHS produced literature, inform parents presenting at Contractor's clinics
about ImmTrac and the benefits of inclusion in ImmTrac.
General Requirement 3C: Work in good faith, and as specified herein, to ensure ImmTrac-registered
private providers use ImmTrac effectively as defined in the DSHS Immunization Contractors Guide for
Local Health Departments. Activities under this requirement shall be conducted in accordance with the
DSHS Immunization Contractors Guide for Local Health Departments.
Activities 3C:
• Provide orientation to all ImmTrac providers at least once a year and maintain documentation of all
technical assistance provided (e.g. telephone logs).
• Explain and demonstrate the effective use of ImmTrac according to the instructions located in the
DSHS Immunization Contractor's Guide for Local Health Departments.
• Explain guidelines for obtaining and submitting ImmTrac consent forms according to the
instructions found at http://www.dshsstate.tx.us/immunize/dots/consent_guidelines.pdf.
• Conduct follow-up with registered ImmTrac providers who are inactive or not using ImmTrac
effectively.
General Requirement 3D: Ensure that ImmTrac data, entered by Contractor's staff, is complete, current,
and accurate. Activities under this requirement shall be conducted in accordance with the DSHS
Immunization Contractors Guide for Local Health Departments.
Activities 3D:
Train Contractor staff on ImmTrac data entry and quality standards.
• Update all demographic information, including address and telephone number, at every client
encounter.
4. PROVIDER QUALITY ASSURANCE (http://www.dshsstate.tx.us/immunize/tuft/tvfc_manualshtm)
EXHIBIT -Page 2
General Requirement 4: Complete 100% of follow-up site visits assigned by DSHS Austin or Health
Service Region staff. Activities under this requirement shall be conducted in accordance with the DSHS
Immunization Contractors Guide for Local Health Departments.
Activities 4:
• Conduct follow-up visits and submit results within deadlines established in the TVFC Operations
Manual.
• Conduct site visits in 100% of subcontracted entities as listed in the Inter-Local Application and
non-Local Health Department WIC immunization clinics, if applicable.
5. PERINATAL HEPATITIS B PREVENTION
(http: //www. dshs. state. tx. us/idcu/disease/hepatitis/hepatitis_b/perinatal/manual/ )
General Requirement SA: 100% of the number of HBsAg-positive pregnant women identified (through
contacts by prenatal health care providers, hospitals, electronic laboratory reporting, regional and Local
Health Departments) will be reported to DSHS. Activities under this requirement shall be conducted in
accordance with the DSHS Immunization Contractors Guide for Local Health Departments and Perinatal
Hepatitis B Prevention Manual.
Activity SA: Contractor staff nurses will participate in targeted training to providers and delivery
hospitals.
General Requirement SB: Work in good faith, and as described herein, to ensure that 100% of the
number of infants born to HBsAg-positive women will receive appropriate and required
immunoprophylaxis including hepatitis B immune globulin (HBIG), the hepatitis B vaccine birth dose and
will complete the Hepatitis B vaccine series. Activities under this requirement shall be conducted in
accordance with the DSHS Immunization Contractors Guide for Local Health Departments and Perinatal
Hepatitis B Prevention Manual.
Activity SB: Conduct Perinatal Hepatitis B case management according to the Perinatal Hepatitis B
Prevention Manual.
General Requirement SC: Work in good faith, and as described herein, to ensure that 100% of the
number of identified infants born to HBsAg-positive women will complete post-vaccination serology
testing or staff will document appropriately if lost to follow-up. Activities under this requirement shall be
conducted in accordance with the DSHS Immunization Contractors Guide for Local Health Departments
and Perinatal Hepatitis B Prevention Manual.
Activity SC: Conduct Perinatal Hepatitis B case management according to the Perinatal Hepatitis B
Prevention Manual.
General Requirement SD: 100% of the number of household and sexual contacts to HBsAg-positive
women will be identified. Activities under this requirement shall be conducted in accordance with the
DSHS Immunization Contractors Guide for Local Health Departments and Perinatal Hepatitis B
Prevention Manual.
Activity SD: Conduct Perinatal Hepatitis B case management according to the Perinatal Hepatitis B
Prevention Manual.
Geueral Requirement SE: 100% of the number of household and sexual contacts to HBsAg-positive
women will complete the Hepatitis B vaccine series or staff will document appropriately if lost to follow-
EXHIBIT -Page 3
up. Activities under this requirement shall be conducted in accordance with the DSHS Immunization
Contractors Guide for Local Health Departments and Perinatal Hepatitis B Prevention Manual.
Activity SE: Conduct Perinatal Hepatitis B case management according to the Perinatal Hepatitis B
Prevention Manual.
6. EDUCATION, INFORMATION, TRAINING, AND COLLABORATIONS
(http://www. dshs. state.tx.us/immunize/providers. shtm)
General Requirement 6A: Conduct educational, promotional, and outreach activities for the general
public to enhance immunization awareness, including distribution of DSHS-provided materials. Activities
under this requirement shall be conducted in accordance with the DSHS Immunization Contractors Guide
for Local Health Departments.
Activities 6A:
• Inform and educate the public about vaccines for all age groups and vaccine-preventable diseases.
Information should include the importance and benefits of being fully vaccinated, vaccine
recommendations, and the location(s) of community vaccination clinics.
• Conduct at least one monthly immunization education activity, document activity (note number &
type of participants), and evaluate activity by obtaining feedback from participants.
• Plan and implement specific activities to promote the importance of Immunizations during National
Infant Immunization Week (NIIW) National Adult Immunization Week (NAIW), and National
Influenza Week.
• Implement written procedures in Contractor clinics to assure that telephone callers who request
information about immunizations receive consistent and correct information.
• Participate in statewide media campaigns by distributing DSHS-developed and produced public
service announcements and materials.
• Participate in special initiatives as directed by DSHS.
• Distribute immunization literature for the public in Contractor's clinic(s), including specific DSHS
materials as directed.
• Provide information to clients, families, and the genera] public on the purpose of ImmTrac, the
benefits of ImmTrac participation, and the importance of maintaining a complete immunization
history in the ImmTrac. Distribute DSHS ImmTrac educational materials during this process.
• Provide hnmTrac public education and ImmTrac literature (including DSHS ImmTrac educational
materials) to community groups and the general public.
• Inform the general public about TVFC, verbally and by distributing TVFC educational materials.
General Requirement 6B: Educate, inform, and train the medical community and local providers within
contractor's jurisdiction on Immunization activities listed below: Activities under this requirement shall be
conducted in accordance with the DSHS Immunization Contractors Guide for Local Health Departments.
Activities 6B: Educate providers on the process to order immunization literature from DSHS
(https://secure.immunizetexasorderform.com/default.aspweb site).
• Inform providers about the annual CDC Epidemiology and Prevention of Vaccine-Preventable
Disease (EPI-VAC) training by referring them to http:/www.cdc.gov/vaccines/ed/broadcast.htm#1.
• Provide training on TVFC requirements and updates (as described in the TVFC Operations Manua()
to TVFC providers annually at a minimum.
• Ensure that the TVFC providers have the most up-to-date DSHS produced immunization
information in their offices.
• Provide training, information, and technical assistance to promote the effective use of ImmTrac by
private providers (which includes education regarding the benefits of ImmTrac participation).
• Educate private providers about the ImmTrac enrollment process and the statutory requirement to
EXHIBIT -Page 4
.~
report immunizations.
• As directed by DSHS, identify first responders and their immediate family in the community and
inform them of the opportunity to be included in ImmTrac.
• Conduct educational training for hospital and health care providers within the Contractor's
jurisdiction, to increase mandatory screening and reporting of HBsAg-positive women.
• Provide training on the prevention of Perinatal Hepatitis B to providers within the Contractor's
jurisdiction.
• Educate physicians, laboratories, hospitals, schools, child-care staff, and other health providers on
VPD reporting requirements.
• Educate and update providers on the most current Advisory Committee on Immunization Practices
(ACID) recommendations for al] age groups, as well as on applicable regulatory vaccination
requirements.
• Provide training relating to Standards for Child and Adolescent Immunization Practices, and
Standards for Adult Immunization Practices
(http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/H/standards-pediatric.pdf and
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/H/standards-adult.pdf) to all
immunization providers within Contractor's jurisdiction.
• Inform all private providers on the federal requirement that the most current Vaccine Information
Statements (VIS) must be distributed to patients
(http://www.cdc.gov/vaccines/pubs/vis/default.htm).
• Promote a health care workforce that is knowledgeable about vaccines, vaccine recommendations,
vaccine safety, vaccine-preventable diseases, and the delivery of immunization services.
• Provide information to community health care employers (hospitals, clinics, doctor's offices, long-
term care facilities) about the importance of vaccination of health care workers.
• Educate private providers to send NIS surveys to the Contractor for research prior to returning the
survey to CDC, if applicable.
Coordinate educational and other activities with local WIC programs to assure that children
participating in WIC are screened and referred to their "medical home" for vaccination using a
documented immunization history in accordance with the Standards for Child and Adolescent
Immunization Practices
(http://www. cdc. gov/vaccines/pubs/p inkbook/downloads/appendices/H/standards-pediatric.pdf).
• Offer educational opportunities to all WIC programs in the service area, including information about
on-line and satellite-broadcast continuing education opportunities from the Centers for Disease
Control and Prevention (CDC) Continuing Education web site
(http://www.cdc.gov/vaccines/ed/default.htm).
General Requirement 6C: Conduct outreach to targeted groups for the promotion of best practices and
special activities related to immunizations. Activities under this requirement shall be conducted in
accordance with the DSHS Immunization Contractors Guide for Local Health Departments.
Activities 6C:
• Conduct outreach (including, but not limited to, the specific outreach described in the DSHS
Immunization Contractors Guide for Local Health Departments) to families of children 19 to 35
months of age who are not up to date on their immunizations according to ImmTrac; locate additional
immunization histories; and enter history data into ImmTrac.
• Collaborate with prenatal health care providers, birth registrars, hospital staff, pediatricians, and other
entities to educate parents, expectant parents, and providers about ImmTrac and the benefits of
participation. Includes the dissemination of DSHS educational materials as appropriate.
• Identify and contact families of children for whom ImmTrac consent has been granted but who do
not have complete immunization records in ImmTrac.
EXHIBIT -Page 5
General Requirement 6D: Conduct recruitment to increase the number of ImmTrac providers, TVFC
providers, and Perinatal Hepatitis B providers. Activities under this requirement shall be conducted in
accordance with the DSHS Immunization Contractors Guide for Local Health Departments.
Activities 6D:
• Conduct recruitment activities as defined in the TVFC Operations Manual with 100% of providers
on the DSHS-supplied provider recruitment list.
• Target adolescent health care providers for recruitment and emphasize adolescent vaccine
requirements and recommendations.
• Recruit new private provider sites for ImmTrac.
• Participate with DSHS regional staff in recruitment of hospitals and providers conducting
surveillance and reporting of Perinatal Hepatitis B.
General Requirement 6E: Establish collaborative efforts with appropriate community entities regarding
promoting immunizations and the reduction of vaccine-preventable diseases. Activities under this
requirement shall be conducted in accordance with the DSHS Immunization Contractors Guide for Local
Health Departments.
Activities 6E:
• Identify providers, hospitals, schools, child care facilities, social service agencies, and community
groups involved in promoting immunizations and reducing vaccine-preventable diseases.
• Maintain a list and contact information for the entities identified under the previous bullet item.
• Summarize all such collaborative efforts, including the specific groups involved, on the tri-annual
report.
7. EPH)EMIOLOGY AND SURVEILLANCE
(http: //www. dshsstate. tx. us/idcu/health/vacc ine~reventable_diseases/resources/vpd~uide. pd~
General Requirement 7: Investigate and document at least 90% of reportable suspected vaccine-
preventable disease cases within 30 days of notification in accordance with DSHS Texas Vaccine-
Preventable Disease Surveillance Guidelines
(http://www.dshs.state.tx.us/idcu/health/vaccine~reventable_diseases/resources/vpd~eride.pdfJ and
National Electronic Disease Surveillance System (NEDSS)
(http://www.cdc.gov/nedss/Archive/Supporing_Public_Health_Surv.pdf ). Activities under this requirement
shall be conducted in accordance with the DSHS Immunization Contractors Guide for Local Health
Departments.
Activities 7:
• Adhere to the DSHS Vaccine-Preventable Disease (VPD) Surveillance Guidelines, NEDSS Data
Entry Guidelines, and Epi Case Criteria Guide in conducting this General Requirement and the
associated activities.
• Complete all data entry into National Electronic Disease Surveillance System (NEDSS) following
the NBSData Entry Guidelines (http:/Iwww.itl.nist.gov/fipspubslfip74.htm).
• Routinely review and follow up on electronic lab reports (ELRs) sent from DSHS.
• Report on steps taken by Contractor to ensure the completeness of VPD reporting within
Contractor's jurisdiction.
8. POPULATION ASSESSMENT
(Immunization Population Assessment Manual (Stock No. 11-12550, Revised 01/08) available upon request
from DSHS.)
EXHIBIT -Page 6
r, f
'J.
General Requirement/Activity 8A: When assigned by DSHS, complete 100% of child-care facility and
Head Start center assessments. Activities under this requirement shall be conducted in accordance with the
DSHS Immunization Contractors Guide for Local Health Departments and Population Assessment Manual.
General Requirement/Activity 8B: When assigned by DSHS, complete 100% of public and private
school assessments, retrospective surveys, and validation surveys. Activities under this requirement shall be
conducted in accordance with the DSHS Immunization Contractors Guide for Local Health Departments
and Population Assessment Manual.
9. SERVICE DELIVERY
General Requirement 9: Provide immunization services and ACID-recommended vaccines in Contractor
clinics to children, adolescents and adults to maximize vaccine coverage levels within contractor's
jurisdiction. Activities under this requirement shall be conducted in accordance with the DSHS
Immunization Contractors Guide for Local Health Departments.
Activities 9:
• Ensure that all ACID-recommended vaccines are routinely available to patients who want them.
• Recommend the simultaneous administration of all needed vaccines for the patient.
• Follow only medically supportable contraindications to vaccination.
• Verbally educate patients and parents/guardians about the benefits and risks of vaccination, and
distribute DSHS educational materials as app]icable as part of this conversation.
• Discuss, and attempt to schedule, the next immunization visit at each client encounter.
• Explain the benefits of a "medical home" and assist the parent/guardian in obtaining or identifying
the child's medical home.
• Use aReminder/Recall system (manual, TWICES, ImmTrac, or other system).
• Establish "standing orders" for vaccination in Contractor clinics, consistent with legal requirements
for standing order (including, but not limited to, those found in the Texas Medical Practice Act).
• Implement an employee immunization policy according to CDC recommendations in Contractor's
clinics.
EXHIBIT -Page 7
~' TEXAS DEPARTMENT OF STATE HEALTH SERVICES
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS GRANTS LOANS AND COOPERATIVE
AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief that:
(l) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to
any person for influencing or attempting to influence an officer or an employee of any agency, a
member of Congress, an officer or employee of Congress, or an employee of a member of Congress in
connection with the awarding of any federal contract, the making of any federal grant, the making of
any federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any federal contract, grant, loan, or woperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of Congress,
an officer or employee of Congress, or an employee of a member of Congress in connection with this
federal contract, grant. loan, or cooperative agreement, the undersigned shall complete and submit
Standazd Fonn LLL, "Disclosure Form to Report Lobbying," in accordance with its instmctions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawazds at all tiers (including subcontracts, subgrants, and contracts under grants,
loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less that $10,000 and not more than $100,000 for each
such failure.
~~eG.w
Signs
',~ ~~~., ~. LSC~Prah,
Print 11lame of Authorized Individual
2008-028046
Application or Contract Number
CORPUS CHRISTI-NUECES COUNTY
PUBLIC HEALTH DISTRICT (CITY)
Organization Name
9~9~8
Date
t~~
R„~,. ARMAUr}n g4pPA I~
CSCU # EF29-12374 -Revised 08.10.07
•. ~ TEXAS DEPARTMENT OF STATE HEALTH SERVICES
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS GRANTS LOANS AND COOPERATIVE
AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief that:
(1) No fedeml appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to
any person for influencing or attempting to influence an officer or an employee of any agency, a
member of Congress, an officer or employee of Congress, or an employee of a member of Congress in
connection with the awarding of any federal contract, the making of any federal grant, the making of
any federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of Congress,
an officer or employee of Congress, or an employee of a member of Congress in connection with this
federal contract, grant. loan, or cooperative agreement, the undersigned shall complete and submit
Standazd Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgran[s, and contracts under grants,
loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less that $10,000 and not more than $100,000 for each
such failure.
~~e`.w
Sig
i~ a~.Q. ~. L~e~P~a~-t,
Print ame of Authorized Individual
2008-028046
Application or Contract Number
CORPUS CHRISTI-NUECES COUNTY
PUBLIC HEALTH DISTRICT (CITY)
Organization Name
~9~6
Date
1417EST -'
naM^n/nn w4aa
CSCU # EF29-12374 -Revised 08.10.07
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